Overview
The following list includes payers that you can check eligibility for through the Eligibility Module.
Payers You May Check in Eligibility
NOTE: If you do not see a payer listed below, Procentive does not currently have the ability to check eligibility for that payer.
Free Payers
- AARP UnitedHealthcare Insurance Company
- Absolute Total Care
- Aetna
- Ambetter
- American Medical Security-All Savers
- Amerigroup
- Amerigroup - Eligibility Only
- Anthem BCBS New Hampshire
- Anthem BCBS (Ohio Medicaid)
- Anthem BCBS of WI
- Beacon Health Options (BHOVO)
- BCBS of Arizona
- BCBS of MN*
- BCBSMN Blue Plus Medicaid Non-Emerg Transportation
- BCBS of ND
- Bright Healthcare
- Capital BC Pennsylvania
- Centene Ohio Medicaid MCE
- Cook Medical Group
- Eastern Maine Healthcare Systems (EMHS) Employee Health Plan
- Empire BlueCross BlueShield HealthPlus
- Florida Blue (BCBS Florida)
- GEHA
- Health Partners of MN*
- Hennepin Health (MHP)*
- Humana - Healthy Horizons (Ohio Medicaid)
- IMCare/Itasca Medical Care*
- John Hopkins Healthcare
- Magellan Health Services
- Marpai Health (Eligibility ONLY)
- Medica
- Medica Government Programs (Medicare Advantage)
- Medica Health Plan Solutions
- Medicaid Minnesota (MN MA/DHS)
- Medicaid Ohio (CareSource)
- Molina Ohio Medicaid MCE
- Morecare
- Nextblue
- Ochsner Health Plan
- Preferred One*
- PrimeWest*
- Regence BCBS Oregon
- Simply Healthcare New
- South Country Health Alliance
- UCare*
- UMR (UMR Wausau)
- United Healthcare (UBH)
- Wellcare Health Plans
- Wellmark BCBS (Iowa, South Dakota)
*Eligibility is free for MN PMAP plans only.
Payers Who Charge a Fee
To prevent unwanted charges from happening, the default setting in every database is to not allow payers who charge a fee. If you would like to change that setting to check eligibility for all available payers regardless of fee, read this article for details: Free Payer Setting for Eligibility Module.
- BCBS Kansas
- BCBS North Carolina
- BCBS of MN
- BIND
- Caprock Health Plans
- Cenpatico WI
- ChampVA
- Cigna
- Compsych
- Dean Health
- Emblem Health
- EMI HEALTH
- Employee Benefit Management System (EBMS)
- Entrust
- Geisinger Health Plan
- Harvard Pilgrim Health Care
- Health Partners
- Hennepin Health
- Highmark BCBS Pennsylvania
- Hometown Health - ELIGIBILITY ONLY
- Humana
- Kemper Health
- Mayo Management Services (MMSI/SCHA)
- Medicaid Florida
- Medicaid Massachusetts
- Medicaid Montana
- Medicaid Nevada (ELIGIBILITY ONLY)
- Medicaid North Carolina
- Medicaid North Dakota
- Medicaid Vermont
- Medicaid WI (Forward Health)
- Molina Healthcare - Affinity by Molina Healthcare
- Preferred One
- Prominence Health Plan
- Reserve National Insurance
- Sanford Health Plan
- Security Health Plan
- Sierra Health Services
- Standard Life and Accident Insurance Company
- Student Resources (Unitedhealthcare)
- Tricare for Life
- TriCare West
- UCare (payer ID 52629 only)
- UnitedHealthCare Community Plan Kansas (KANCARE)
- US Family Health Plan
- Wilson McShane
Fee: For each eligibility check you send for a payer that charges, an invoice starts to accumulate based on the payers' charge and averages. Please reach out for more information.
- Report 4070 will display these costs for you for a given time period.